A 66-year-old woman presented with 2 weeks of debilitating right upper-limb pain with a vesicular rash over the right C5 dermatome secondary to herpes zoster. Her pain failed to improve with: oral narcotics, divalproex, gabapentin, pregabalin, and topical 2% lidocaine cream. Six weeks postonset, a right C5 transforaminal epidural steroid injection (TESI) under fluoroscopic guidance was performed. Prior to the injection, her numeric pain intensity was rated as 9 to 10/10, and 15 minutes after the injection, it was reduced to 3/10. At 2 weeks, her pain had maintained an intensity of 3/10 and over another 2 weeks had resolved. She remained pain-free 3 months later. In this case, the use of a cervical TESI provided dramatic results in the treatment of debilitating postherpetic neuralgia (PHN). Further investigation is needed to determine the efficacy of TESI in the early management of PHN
Keywords : Aged,Cervical Vertebrae,drug therapy,Female,Fluoroscopy,Glucocorticoids,Herpes Zoster,Humans,Injections,Epidural,Lidocaine,Narcotics,Neuralgia,Neuralgia,Postherpetic,Pain,Pain Measurement,physiopathology,Pregabalin,secondary,Spine,therapeutic use,Triamcinolone,, Neuralgia,Involving,Right,C5, cervical trigger points
Date of Publication : 2007 Feb
Authors : Shakir A;Kimbrough DA;Mehta B;
Organisation : Western Reserve Spine and Pain Institute, Kent, OH 44240, USA. docshakir@hotmail.com
Journal of Publication : Arch Phys Med Rehabil
Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/17270526
The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery
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